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Chapter 12 - Eating Disorders

from Part III - Application and Adaptations for Mental Health Presentations

Published online by Cambridge University Press:  18 May 2023

Anthony Bateman
Affiliation:
Anna Freud National Centre for Children and Families, London
Peter Fonagy
Affiliation:
University College London
Chloe Campbell
Affiliation:
University College London
Patrick Luyten
Affiliation:
University College London
Martin Debbané
Affiliation:
University College London
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Summary

There is considerable evidence of mentalizing problems in patients with eating disorders, with non-mentalizing modes, especially in relation to body weight and shape, being dominant. The mentalizing model assumes the existence of developmental vulnerabilities, especially during adolescence, and that the range of different symptoms associated with eating disorders may have the common function of being attempts at social self-regulation. Controlling eating is a way of managing social and emotional developmental milestones that the person perceives as insuperable. Patients with eating disorders become stuck in a low mentalizing experience of themselves and their bodies. Clinical treatment based on this formulation is discussed as it is applied in a combined program of individual and group psychotherapy, together with psychoeducation.

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